Understanding the antecedents to retirement and bridge employment is important to older-aged adults who seek ways to smoothly transition to full retirement, and to organizations that benefit from ...retaining their highly skilled and most experienced workers, especially in occupations for which labor shortages are projected. We tested the effects of affective, continuance, and normative commitment to organizations and to occupations on older-aged pharmacists' (
N
=
294) intentions to fully retire and to pursue three types of bridge employment. As hypothesized, criteria that were more organizationally focused (e.g., bridge employment in the same organization) were predicted more strongly by organizational, rather than occupational, commitment. For one type of bridge employment that was more occupationally focused—bridge employment in a different field—the hypothesized differential effects were supported, such that it was predicted more strongly by occupational, rather than organizational, commitment. We discuss the implications of our findings for theory, research, and practice.
Enhancing Quality of Life (QOL) has long been an explicit or implicit goal for individuals, communities, nations, and the world. But defining QOL and measuring progress toward meeting this goal have ...been elusive. Diverse “objective” and “subjective” indicators across a range of disciplines and scales, and recent work on subjective well-being (SWB) surveys and the psychology of happiness have spurred interest. Drawing from multiple disciplines, we present an integrative definition of QOL that combines measures of human needs with subjective well-being or happiness. QOL is proposed as a multi-scale, multi-dimensional concept that contains interacting objective and subjective elements. We relate QOL to the opportunities that are provided to meet human needs in the forms of built, human, social and natural capital (in addition to time) and the policy options that are available to enhance these opportunities. Issues related to defining, measuring, and scaling these concepts are discussed, and a research agenda is elaborated. Policy implications include strategies for investing in
opportunities to maximize QOL enhancement at the individual, community, and national scales.
To explore how rheumatoid arthritis (RA) antirheumatic drug-specific knowledge and numeric literacy, patient trust in physician, and demographic and disease-related factors relate to the confidence ...of patient decision-making related to disease modifying antirheumatic drugs (DMARD).
Data were analyzed from 628 randomly selected patients with RA receiving care in community rheumatology practices, who responded to a multicenter, cross-sectional mail survey. We used multiple regression models to predict patient confidence in DMARD decision-making related to their most recently initiated DMARD.
Significant positive correlation was found between confidence in DMARD decision and trust in physician, DMARD-specific knowledge, and disease duration, but not risk-related numeric literacy, sex, or education. Negative correlations were found with disease severity and current bother with DMARD side effects. A multiple linear regression model of confidence in DMARD decision had an overall R = 0.788, R2 = 0.620 (p < 0.001). The 4 dependent variables contributing significantly to the model were female sex, Medicaid insurance status, satisfaction with RA disease control, and trust in physician, with standardized beta = 0.077, -0.089, 0.147, and 0.687, respectively.
In this sample of community patients with RA, the patient trust in physician had substantially greater effect on confidence in DMARD decision than DMARD-specific knowledge, disease-related factors, or demographic characteristics.
This chapter considers inclusive communities as a form of support for people with learning disabilities (LDs). There are one-and-a-half million people with LDs in the UK. Many of these people believe ...that a gap exists between UK policy and reality, made worse by recent cuts in public spending. Nevertheless, there has been progress in this area. The chapter first explains what a learning disability is and how it presents before providing a brief historical background on UK government policies aimed at protecting and promoting the rights of people with LDs. It then discusses some of the major challenges involved in providing care and support for people with LDs, focusing on issues relating to health inequalities, employment, mental health, improving decision-making by people with LDs, housing, and financial constraint. The chapter concludes with an assessment of future prospects for services for people with LDs.
Special collections in academic libraries provide rich learning environments for student engagement. This article describes the introduction of an independent study course by an academic library ...department as a high-impact educational practice supporting undergraduate research. Under the supervision of the faculty archivist, the student in this study was challenged to discover and research “gems,” unusual or significant items, on a topic of her choosing. She selected three works related to James Joyce’s Finnegans Wake, showcasing her research at the university’s Student Faculty Research Symposium and creating a library display as her final project. This case study explores background information and describes the course, its inception, and the student’s project. It includes a discussion of benefits and challenges, transferability, scalability, and the application of a constructivist approach to teaching and learning. Limitations and further research are also included in this study.
OBJECTIVE: To assess the influence of race and gender influence on the use of invasive procedures in patients with acute myocardial infarction (AMI) in community hospitals.
DESIGN: Prospective, ...observational.
SETTING: Five mid‐Michigan community hospitals.
PATIENTS: All patients (838) identified with AMI between January 1994 and April 1995 in 1 of these hospitals.
MEASUREMENTS AND MAIN RESULTS: After adjusting for age, hospital of admission, insurance type, severity of AMI, and comorbidity, using white men as the reference group, the rate of being offered cardiac catheterization (CC) was 0.88 (95% confidence interval 95% CI, 0.60 to 1.29) for white women; 0.79 (95% CI, 0.41 to 1.50) for black men; and 1.14 (95% CI, 0.53 to 2.45)for black women. Among patients who underwent CC, after also adjusting for coronary artery anatomy, the rate of being offered angioplasty, using white men as the reference group, was 1.22 (95% CI, 0.75 to 1.98) for white women; 0.61 (5% CI, 0.29 to 1.28, P = .192) for black men; and 0.40 (95% CI, 0.14 to 1.13) for black women The adjusted rate of being offered bypass surgery was 0.47 (95% CI, 0.24 to 0.89) for white women; 0.36 (95% CI, 0.12 to 1.06) for black men; and 0.37 (95% CI, 0.11 to 1.28)for black women.
CONCLUSIONS: Our study shows that white women are less likely than white men to be offered bypass surgery after AMI. Although black men and women with AMI are less likely than white men to be offered percutaneous transluminal coronary angioplasty or coronary artery bypass grafting in both unadjusted and adjusted analyses, these findings did not reach statistical significance. Our study is limited in power due to the small number of blacks in the sample.
The purpose of this pilot study was to assess the feasibility of a Tai Chi workplace wellness program as a cost effective way of improving physical and mental health, reducing work related stress, ...and improving work productivity among older nurses in a hospital setting Design A randomized control trial of two groups (control and Tai Chi group).
A randomized control trial of two groups (control and Tai Chi group).
Northeastern academic medical center.
A convenience sample of eleven female nurses (mean age 54.4 years).
The Tai Chi group (n = 6) was asked to attend Tai Chi classes once a week offered at their worksite and to practice on their own for 10 minutes each day at least 4 days per week for 15 weeks. Controls (n = 5) received no intervention.
SF-36 Health Survey, Nursing Stress Scale (NSS), Perceived Stress Scale (PSS), Sit-and-Reach test, Functional Reach test, the Work Limitations Questionnaire, workplace injury and unscheduled time off.
The two study groups were compared descriptively and changes across time in the intervention versus control were compared.
The Tai Chi group took no unscheduled time-off hours, whereas, the control group was absent 49 hours during the study period. There was also a 3% increase in work productivity and significant improvement in functional reach (p=0.03) compared to the control group. Other outcomes were not statistically significant.
This pilot study demonstrates the feasibility of Tai Chi with older female workers as a cost effective wellness option in the workplace; thus encouraging replication with a larger sample. Methodological implications were also addressed.
The influences of both paid and unpaid productive activity outside the home on positive and negative affect among White and Black males and females were examined in this study. Data are from a ...weighted subsample of those 60 and over from Wave 1 (1986) of the Americans' Changing Lives Panel Study. Multivariate analyses confirm the basic thesis that race and gender are critical social contexts when considering the relationship between productive activity and positive and negative affect. Major findings are: (a) paid work has no direct influence on either positive or negative affect for any of the four race/gender subgroups; (b) formal religious participation decreases the negative affect of older Black women; (c) formal nonreligious participation increases the positive affect of White men and decreases the negative affect of Black men; (d) informal volunteering increases positive affect and decreases negative affect among older Black men and White women. Discussion focuses on the importance of role distinctions by race in explaining the various productive activity/affect associations.
OBJECTIVE: To examine changes in the rate of beta‐blocker (BB) use at admission, in hospital, and at discharge between 1994 and 1995 (MICH I) and 1997 (MICH II) in patients with acute myocardial ...infarction (AMI).
DESIGN: Comparison of two prospectively enrolled cohorts.
SETTING: Five mid‐Michigan community hospitals.
PATIENTS: We studied 287 MICH I patients and 121 MICH II patients with AMI who had no contraindications to BB use from cohorts of consecutively admitted cases of AMI (814 in MICH I; 500 in MICH II).
RESULTS: Prescription of BBs to ideal patients with AMI increased in patients with previous history of myocardial infarction on arrival at the hospital (12.5% vs 36.0%; P= .01), in hospital (47.0% vs 76%; P < .01), and at discharge (34.0% vs 61.9%; P < .01). Neither race nor gender was a predictor of BB use. Younger age predicted BB prescription at discharge (odds ratio OR, 2.07; 95% confidence interval CI, 1.32 to 3.23). Later study cohort was the most important predictor of BB use in hospital (OR, 3.4; 95% CI, 2.09 to 5.25).
CONCLUSION: BB use improved dramatically over the study period, but additional work is needed to improve use of BB after discharge and among elderly patients with AMI.
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